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Научно-практическая ревматология

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Коронавирусная болезнь 2019 (COVID-19) и аутоиммунитет

https://doi.org/10.47360/1995-4484-2021-1

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Аннотация

Пандемия коронавирусной болезни 2019 (coronavirus disease, COVID-19), этиологически связанной с вирусом SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2), привлекла внимание медицинского сообщества к новым клиническим и фундаментальным проблемам иммунопатологии заболеваний человека. В течение года, прошедшего с начала пандемии, было проведено беспрецедентное число клинических и фундаментальных исследований, посвященных проблемам эпидемиологии, вирусологии, иммунологии и молекулярной биологии, клинического течения, полиморфизма и фармакотерапии COVID-19, объединивших ученых и врачей практически всех биологических и медицинских специальностей. Эти усилия увенчались созданием нескольких типов вакцин против инфекции SARS-CoV-2 и в целом разработкой более рациональных подходов к ведению пациентов. 2020 год является юбилейным, поскольку именно 70 лет назад (в 1950 году) Т. Рейхштейн, Э. Кендалл и Ф. Хенч были удостоены Нобелевской премии, за «открытия, касающиеся гормонов коры надпочечников, структуры и биологических эффектов». Не менее важное значение имеют исследования, касающиеся применения генно-инженерных биологических препаратов и «таргетных» противовоспалительных препаратов, модулирующих внутриклеточную сигнализацию цитокинов, которые в течение последних 20 лет специально разрабатывались для лечения иммуновоспалительных ревматических заболеваний (ИВРЗ). В процессе детального анализа спектра клинических проявлений и иммунопатологических нарушений при COVID-19 стало очевидным, что инфекция SARS-CoV-2 сопровождается развитием широкого спектра экстрапульмональных клинических и лабораторных нарушений, некоторые из которых характерны для ИВРЗ и других аутоиммунных и аутовоспалительных заболеваний человека. Все вместе это послужило основанием для «репозиционирования» (drug repurposing) и применения по незарегистрированным показаниям (off-label) при COVID-19 противовоспалительных препаратов, ранее специально разработанных для лечения ИВРЗ. В статье обсуждаются перспективы лечения COVID-19 с использованием глюкокортикоидов, генно-инженерных биологических препаратов, ингибиторов JAK и других препаратов, блокирующих эффекты провоспалительных цитокинов.

Об авторе

Е. Л. Насонов
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)
Россия

115522, Москва, Каширское шоссе, 34а;
119991, Москва, ул. Трубецкая, 8, стр. 2



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Для цитирования:


Насонов Е.Л. Коронавирусная болезнь 2019 (COVID-19) и аутоиммунитет. Научно-практическая ревматология. 2019;:5-30. https://doi.org/10.47360/1995-4484-2021-1

For citation:


Nasonov E.L. Coronavirus disease 2019 (COVID-19) and autoimmunity. Rheumatology Science and Practice. 2019;:5-30. (In Russ.) https://doi.org/10.47360/1995-4484-2021-1

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